May 2016

Shared decision making involves talking with patients finding out what matters to them and helping them incorporate that into what treatment plan they will follow Illustration by David Cutler

Sustained change a challenge for health

Health-linked incentives have become increasingly common, particularly by employers. But researchers are still trying to sort out what type and design of incentives are most effective and whether they hold significant potential to achieve both short- and long-term behavioral changes.

Managing depression is worth the effort

Depression's impact on health is often profound and far-reaching, potentially equaling that of coronary artery disease. To provide clinicians with guidance on treatment of depression, ACP has released a new clinical practice guideline that underscores the severe burden of depression and outlines viable treatment options for patients.

Allergies are on the rise, but so are treatments

Environmental allergies are becoming more prevalent, and fortunately, so are treatments, as internists and allergists recommend options from changing the immediate environment to immunotherapy.

Clarity of vision sets the stage for ACP's work

Much has been achieved in the past year, such as repealing the sustainable growth rate formula. New goals include advocating for further changes to Maintenance of Certification and helping physicians transition to new models of care delivery.

ACP's prescription for rising drug costs

ACP has 4 concrete proposals to address rising prescription drug prices: regulating and negotiating prices, enhancing transparency, increasing competition, and considering value.

Incentives research must balance carrots and sticks

This issue covers topics such as offering incentives to help patients change their lifestyles, treating depression and its extensive influence on overall health, and new modalities for treating allergies.

Dealing with the hassles of prior authorization

Prior authorization related to medications or referrals to specialty care or testing drain physician and staff time on burdensome administrative tasks instead of patient care. Practices can try some tips to mitigate some of the burdens.

Approval for cancer drug; proposed ban for gloves

This update covers approval of Crizotinib (Xalkori) to treat people with metastatic non-small-cell lung cancer whose tumors have an ROS-1 gene alteration.

MKSAP Quiz: Decreased exercise tolerance

A 62-year-old woman is evaluated for a 4-month history of decreased exercise tolerance, joint stiffness, mild weakness, and a rash on her hands. She has noted increasing difficulty carrying heavy objects and feels exhausted after climbing stairs. Although her joints are stiff, she has not had any joint swelling. Her rash developed around the time of her other symptoms and has not responded to over-the-counter topical agents. She has no other symptoms, including cough or dyspnea. Medical history is unremarkable, and she takes no medications. Follow a physical exam, cardiopulmonary exam, and lab studies, which of the following pulmonary conditions is associated with this patient's clinical presentation?.